Reirradiation of head and neck cancer: Long-term disease control and toxicity

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Title:	Reirradiation of head and neck cancer: Long-term disease control and toxicity
Author(s):	Bots, W.T.C.; Bosch, S van den; Zwijnenburg, E.M.; Dijkema, T.; Broek, G.B. van den; Weijs, W.L.J. ; Verhoef, L.C.G. ; Kaanders, J.H.A.M.
Publication year:	2017
Source:	Head and Neck-Journal for the Sciences and Specialties of the Head and Neck, vol. 39, iss. 6, (2017), pp. 1122-1130
ISSN:	1043-3074
DOI:	http://dx.doi.org/10.1002/hed.24733
Publication type:	Article / Letter to editor
Please use this identifier to cite or link to this item : http://hdl.handle.net/2066/174296
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Subject:	Radboudumc 9: Rare cancers RIHS: Radboud Institute for Health Sciences
Organization:	Radiation Oncology Otorhinolaryngology Oral and Maxillofacial Surgery
Journal title:	Head and Neck-Journal for the Sciences and Specialties of the Head and Neck
Volume:	vol. 39
Issue:	iss. 6
Page start:	p. 1122
Page end:	p. 1130
Abstract:	BACKGROUND: The purpose of this study was to report long-term disease control and late radiation toxicity for patients reirradiated for head and neck cancer. METHODS: We conducted a retrospective analysis of 137 patients reirradiated with a prescribed dose >/=45 Gy between 1986 and 2013 for a recurrent or second primary malignancy. Endpoints were locoregional control, overall survival (OS), and grade >/=4 late complications according to European Organization for Research and Treatment of Cancer (EORTC)/Radiation Therapy Oncology Group (RTOG) criteria. RESULTS: Five-year locoregional control rates were 46% for patients reirradiated postoperatively versus 20% for patients who underwent reirradiation as the primary treatment (p < .05). Sixteen cases of serious (grade >/=4) late toxicity were seen in 11 patients (actuarial 28% at 5 years). In patients reirradiated with intensity-modulated radiotherapy (IMRT), a borderline improved locoregional control was observed (49% vs 36%; p = .07), whereas late complication rates did not differ. CONCLUSION: Reirradiation should be considered for patients with a recurrent or second primary head and neck cancer, especially postoperatively, if indicated. (c) 2017 Wiley Periodicals, Inc. Head Neck 39: 1122-1130, 2017.